Calculating Future 10-Year Breast Cancer Risks in Risk-Adapted Surveillance: A Method Comparison and Application in Clinical Practice

The German Consortium for Hereditary Breast and Ovarian Cancer (GC-HBOC) has successfully implemented risk-adapted breast cancer surveillance for women at high breast cancer risk in Germany. Women with a family history of breast and ovarian cancer but without pathogenic germline variants in recognized breast cancer risk genes are recommended annual breast imaging if their predicted 10-year breast cancer risk is 5% or higher, using the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) breast cancer risk model, as outlined in the current GC-HBOC guideline. However, women who initially do not meet this risk threshold may do so later, even if there is no new cancer in their family. To determine when this threshold is crossed, one could annually repeat BOADICEA calculations using an aging pedigree: the "prediction by aging pedigree" (AP) approach. Alternatively, we propose a simplified and more practical "'conditional probability" (CP) approach, which calculates future risks based on the initial BOADICEA assessment. Using data from 6,661 women registered with GC-HBOC, both methods were compared. Initially, 74% of women, ages 30 to 48 years, had a 10-year breast cancer risk below 5%, but 53% exceeded this threshold at an older age based on the AP approach. Among the women with an initial risk below the threshold, the CP approach revealed that 99% of women exceeded the 5% threshold at the same or an earlier age compared with the AP approach (88% of cases were within the same year or 1 year earlier). The CP approach has been implemented as a user-friendly web application. Prevention Relevance: The German Consortium for Hereditary Breast Cancer recommends annual breast imaging for women if their 10-year breast cancer risk is 5% or higher. Women who initially do not meet this risk threshold may do so later. We propose a simple method to determine future risks based on initial risk assessments.

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Publication Details

Journal
Cancer Prevention Research
Published
2024-11-22
DOI
https://doi.org/10.1158/1940-6207.capr-24-0328
Citations
1
Primary Topic
BRCA gene mutations in cancer
Type
article
Field-Weighted Citation Impact
0.55

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article

Calculating Future 10-Year Breast Cancer Risks in Risk-Adapted Surveillance: A Method Comparison and Application in Clinical Practice

Marion van Mackelenbergh, Pablo Villavicencio‐Lorini, Elena Leinert, Christine Solbach et al.
1 citations
Cancer Prevention Research
BRCA gene mutations in cancer
0.55
article

Calculating Future 10-Year Breast Cancer Risks in Risk-Adapted Surveillance: A Method Comparison and Application in Clinical Practice

Marion van Mackelenbergh, Pablo Villavicencio‐Lorini, Elena Leinert, Christine Solbach, Malgorzata Banys-Paluchowski, Nicola Dikow, Mirjam Schönfeld, Dorothee Speiser, Juliane Hoyer, Christoph Engel, Christiane D. Much, Daniel Pieh, Bahriye Aktas, Anne S. Quante, Silke Zachariae, Ulrich A. Schatz, C Meisel, Bernhard H. F. Weber, G. Faigle, Yasmin Mehraein, Marion B. Kiechle, Dennis Witt, Joelle Ronez, Tanja Fehm, Kerstin Rhiem, Rita K. Schmutzler, Christine Fischer, Josef Schröder, Jane Horvath, Alma-Verena Mueller-Rausch
article en
1 citations

Abstract

The German Consortium for Hereditary Breast and Ovarian Cancer (GC-HBOC) has successfully implemented risk-adapted breast cancer surveillance for women at high breast cancer risk in Germany. Women with a family history of breast and ovarian cancer but without pathogenic germline variants in recognized breast cancer risk genes are recommended annual breast imaging if their predicted 10-year breast cancer risk is 5% or higher, using the Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) breast cancer risk model, as outlined in the current GC-HBOC guideline. However, women who initially do not meet this risk threshold may do so later, even if there is no new cancer in their family. To determine when this threshold is crossed, one could annually repeat BOADICEA calculations using an aging pedigree: the "prediction by aging pedigree" (AP) approach. Alternatively, we propose a simplified and more practical "'conditional probability" (CP) approach, which calculates future risks based on the initial BOADICEA assessment. Using data from 6,661 women registered with GC-HBOC, both methods were compared. Initially, 74% of women, ages 30 to 48 years, had a 10-year breast cancer risk below 5%, but 53% exceeded this threshold at an older age based on the AP approach. Among the women with an initial risk below the threshold, the CP approach revealed that 99% of women exceeded the 5% threshold at the same or an earlier age compared with the AP approach (88% of cases were within the same year or 1 year earlier). The CP approach has been implemented as a user-friendly web application. Prevention Relevance: The German Consortium for Hereditary Breast Cancer recommends annual breast imaging for women if their 10-year breast cancer risk is 5% or higher. Women who initially do not meet this risk threshold may do so later. We propose a simple method to determine future risks based on initial risk assessments.

Cancer Prevention ResearchVol. 18(2)
Goethe University Frankfurt (DE), Universität Hamburg (DE), University of Freiburg (DE), University of Cologne (DE), Friedrich-Alexander-Universität Erlangen-Nürnberg (DE), Universität Ulm (DE), Johannes Gutenberg University Mainz (DE), Heidelberg University (DE), Universitätsmedizin Greifswald (DE), University Medical Center Freiburg (DE), University Hospital Heidelberg (DE), TUM Klinikum (DE), University Hospital Regensburg (DE), Medizinische Hochschule Hannover (DE), Universität Greifswald (DE), Düsseldorf University Hospital (DE), University Medical Center of the Johannes Gutenberg University Mainz (DE), University Hospital Münster (DE), University Medical Center Hamburg-Eppendorf (DE), University Hospital Schleswig-Holstein (DE), Universitätsmedizin Göttingen (DE), Institute of Human Genetics (PL), Breast Center (CH), University Hospital Leipzig (DE), Cardiovascular Center Frankfurt (DE), Technical University of Applied Sciences Lübeck (DE), University Hospital Frankfurt (DE), University Hospital Cologne (DE), University Hospital Ulm (DE), University Hospital Carl Gustav Carus (DE), Technische Hochschule Ulm (DE), Heinrich Heine University Düsseldorf (DE), University of Regensburg (DE), Technical University of Munich (DE), Martin Luther University Halle-Wittenberg (DE), University of Göttingen (DE), Charité - Universitätsmedizin Berlin (DE), University of Tübingen (DE), Ludwig-Maximilians-Universität München (DE), Leipzig University (DE), University of Lübeck (DE)
Bundesministerium für Bildung und Forschung, Deutsche Krebshilfe
Good health and well-being
Openalex Percentile: Top 24%
BRCA gene mutations in cancer
0.55
DOIOpen Access PDFOpenAlex
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